| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $42.66 | $67.61 | $97.72 | |
Aetna
| Professional | $38.90 | $48.98 | $61.66 | |
Anthem BCBS
| Professional | $30.20 | $39.81 | $51.29 | |
CareSource
| Facility | $38.90 | $52.48 | $74.13 | |
CareSource
| Professional | $38.90 | $54.95 | $75.86 | |
Cigna
| Facility | $75.86 | $75.86 | $75.86 | |
Cigna
| Professional | $46.77 | $70.79 | $275.42 | |
Molina
| Professional | $32.36 | $33.11 | $37.15 | |
United
| Professional | $46.77 | $63.10 | $93.33 |